Sunday, August 23, 2009

Unprecedented Realism

“There are few people who are not ashamed of their love affairs when the infatuation is over.”

- François, Duc De La Rochefoucauld

The end of an infatuation is always rather sad – we have many expressions for it, “the bloom is off the rose” comes to mind. Falling out of love is often a moment of maturity, a moment of coming out of an illusion – never wholly welcome.

We have had many decades of uncritical, wholesale adolescent-style adoration, heartbreak and hate towards our politicians. We have been capable of sustaining illusions and uncritical thought with support from a similarly dazzled media. This has been done for years on both sides of the aisle. This kind of idealism says that we have finally found the man (party) who will (choose one) solve our problems, understand us, have complete integrity, be able to function in a trustworthy and honest fashion. This idealism comforted us by putting some in black hats and some in white. The comforts of certainty, zeal and clarity, even if untrue, are hard to resist. How long we can sustain this with any one politician or party depends on the filter we have, and how much attention we are paying. This is how crushes are sustained, in romance and in politics.

There are signs on the ground that we are beginning to grow up. We are beginning to understand that the corruption, self-interest, special interests and spin exist symbiotically on both sides of the aisle. With the deeply personal debate on health care and its associated reform costs, our need for honesty and successful policy to save our country is suddenly more important to us than the comfort of bedtime stories. This is political maturity.

What are the signs of this? Take for example, the publics’ realization that our representatives have not read a bill in its entirety. This conversation did not even occur as little as ten years ago – we assumed a level of expertise by our elected officials, or we didn’t care, but somehow, and this is the point, the illusion was maintained. In retrospect, I would imagine few bills were ever read page by page – and that the fact that they are not now is nothing new. What is new is that we now care about this. What is new is that we now see that legislation has a direct impact upon us. What is new is that we realize this congressional neglect shelters corruption in the form of deals, earmarks and policy that the public would not support if there was transparency. And we now see that there is transparency not provided by a beneficent body of elected officials or trusted news sources, but rather there is transparency because of the internet. It is unprecedented that we can summon chapter and verse of any bill onto our own computer – almost in real time.

This is a game-changer.

We are now (as voters) in a position to demand that legislation (including I daresay health-care reform) occur in incremental, transparent, understandable terms that voting citizens can vet themselves. Not thousands of pages of nearly incomprehensible gobbledygook. Anything short of that has become unacceptable, in part because we are also now able to contact our representatives at a moments notice. In years to come, we will now look back and see the final lipstick-on-the-collar moment in our relationship with Congress as the ramming through of the unread, un-vetted Stimulus Package.

The bloom is off the rose. It’s time for a new kind of politics: a mature, unprecedented realism.

Politicians should dismiss the public as “not ready for this” at their own risk.

This is a welcome change in the development of our culture, and not a minute too soon. At shareholder's meetings in European companies, it is not uncommon to get hard, critical questions and comments from the audience. This is the kind of input we need for the healthcare debate.

How amazingly accurate this is. I believe transparency was the original intent of the founding fathers, a government of, by and for the people, not corporate interests or special interest groups. Could this be the era where we actually demand that politicians do their jobs? An era of accountability rather than assumption? I remember the old saying, the hand is quicker than the eye. Well the way recent legislation has been signed off, thats never been more true.

I hope people of all parties and positions could agree that this is fundamental. It is non-partisan to demand that the President and all politicians show how they have carefully researched their proposals.

It is not our job to read tea leaves and pick apart 1000 page bills written in Old English to figure out what the bills are really saying. The bills are not enough. They are implementation, not coherent policy. We have been directed to look only at the bills as a tactic to make the press and public scratch for the underlying ideas.

Did Obama (or any politician) start with such a policy study, or not?If so, then where is it? If not, then he is a fool. And we are fools if we accept legislation without explanation.

Is Obama legislating from some scribbles on a cocktail napkin?Does he want to pass anything, then rearrange it later to do what he wants?

Where is the policy paper?If they won't answer:OK, so where is the cocktail napkin?

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.